Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Small animal practitioners are increasingly confronted with patients showing adaptation related problems (ARP) which are expressed as disturbed or abnormal behavior (DAB). As a result, practitioners are asked increasingly to euthanize animals which seemingly cannot be socialized. In healthy dogs and cats, three main causes for DAB can be detected: refusal of obedience because of the drive for dominance; anxiety and frustration; and geriatric DAB. Increasingly, disease conditions not readily diagnosed can cause DAB, especially hypothyroidism. Influencing and contributing factors to DAB are breed, sex, experiences as a puppy, behavior of owners, changes in the pet's environment. ARPs may also cause disturbances in the condition of skin and fur, e.g. atopic dermatitis, pruritus sine materia, lick granuloma, and of the intestinal organs (vomiting, irritated bowel syndrome) and may result in an immune deficiency. Therapeutic approaches include behavioral therapy, surgical or hormonal castration with progestins or antiandrogens, substitution with thyroxin in cases with hypothyroidism, and/or the use of psychopharmaca, most prominently of modern antidepressiva like amitriptyline; buspirone; clomipramine and fluoxetine, but also of selegiline, a mono-aminoxydase inhibitor. These compounds, among other effects, are elevating prolactin levels. This seems to allow to formulate a working hypothesis: in the canine species, prolactin is obviously a hormone enabling socialization; hence all drugs which safely cause an increase in prolactin production might be suitable to manage or control ARPs and DAB in the dog, but also in the cat. Higher levels of prolactin than those required for socialization, as seen in nursing bitches or some clinically overt cases of pseudopregnancy, may cause maternal aggression and can be controlled with prolactin inhibitors, if needed.
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PMID:[Abnormal behavior and adaptation problems in dogs and cats and their pharmacologic control]. 985 23

A 45-year-old woman had pyrexia, headaches, collapse and hyponatraemia. Intracerebral abscess, bacterial meningitis and subarachnoid haemorrhage were excluded. She was given intravenous antibiotics and gradually recovered. One month later she was readmitted with diplopia, headache and vomiting. Serum sodium was low (107 mmol/l) and a diagnosis of inappropriate ADH secretion was made. MRI scan showed a suprasellar tumour arising from the posterior pituitary gland. A skin rash gradually faded. Serum cortisol, prolactin, gonadotrophins and thyroid hormone levels were low. A pituitary tumour was removed trans-sphenoidally, she had external pituitary radiotherapy, and replacement hydrocortisone and thyroxine. She was well for 12 months when she developed progressive weakness and numbness of both legs. Examination suggested spinal cord compression at the level of T2 where MRI scanning showed an intradural enhancing mass. This spinal tumour was removed and her neurological symptoms disappeared. Nine months after this she developed facial pain and nasal obstruction. CT scan showed tumour growth into the sphenoid sinus and nasal cavities. A right Cauldwell-Luc operation was done and residual tumour in the nasal passages was treated by fractionated external radiotherapy and Prednisolone. Histological examination of the specimens from pituitary, spinal mass, and nasal sinuses showed Rosai-Dorfman disease, a rare entity characterized by histiocytic proliferation, emperipolesis (lymphophagocytosis) and lymphadenopathy. Aged 48 she developed cranial diabetes insipidus. Although Rosai-Dorfman syndrome is rare, it is being reported with increasing frequency, and should be borne in mind as a possible cause of a pituitary tumour.
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PMID:Rosai-Dorfman disease presenting as a pituitary tumour. 1034 67

The effect and side reactions of bromocriptin of the firm "Richter" were evaluated in this study. Fifteen women with interrupted pregnancy between 14 and 28 gestational week were explored. To prevent the onset of lactation treatment was started within a few hours after abortion in dosage 2.5 mg (one tablet) twice daily, for 14 days. The prolactin-lowering action began to take effect 2 hours after ingestion of the first tablet, peak after 5 hours, and maintained for 8-12 hours. In course of treatment 14 days in dosage two times daily, the lactation was inhibited in 100% of the cases, in 65% of them she was stopped at the first three days of therapy, in 15% of the cases she was stopped between 3rd and 7th day, and in 20%--after the 7th day of the treatment. The adverse reactions nausea, dizziness, vomiting, diarrhoea, constipation, headache and orthostatic hypotension were transitory. They were observed rarely, and during the first 3-5 days of treatment disappeared.
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PMID:[The use of bromocryptin--Richter for the suppression of the onset of lactation after the interruption of pregnancy between the 14th and 28th gestational weeks--a preliminary report]. 1072 58

Clinical evidence and recent genetic findings seem to indicate an involvement of dopamine in the pathophysiology of the migraine attack. Prodromal symptomatology (mood changes, yawning, drowsiness, food craving), accompanying symptoms (nausea, vomiting, hypotension) and postdromal symptoms (mood changes, drowsiness, tiredness) may be related to dopaminergic activation. The dopaminergic system could also play a role in the headache phase, either by taking part in nociception mechanisms, or by regulating cerebral blood flow. A body of pharmacological findings seems to support this involvement. Migraine patients, between attacks, show a higher responsiveness to acute administration of dopaminergic agents. Apomorphine administration induces in migraineurs more yawns as well other dopaminergic symptoms e.g. nausea, vomiting, dizziness. Migraine has been associated with hypotension and, occasionally, with syncope. Bromocriptine causes severe orthostatic syndrome in migraine patients. Both piribedil and apomorphine markedly increase cerebral blood flow of migraine patients, thus indicating enhanced responsiveness of dopamine receptors which are involved in cerebral blood flow regulation. Interictal dopaminergic hypersensitivity has also been demonstrated by means of neuroendocrine tests. Altered dopaminergic control of prolactin secretion exists in migrainous women. L-deprenyl, a MAO-B inhibitor, is significantly more effective in reducing prolactin levels in migraineurs than in controls. Taken together, these findings support the view that hypersensitivity of peripheral and central dopaminergic receptors is a specific migraine trait. Finally, a high density of lymphocytic D5 receptors has been found in migraine sufferers, thus suggesting their upregulation. Therefore, the hypothesis that dopaminergic activation is a primary pathophysiological component in certain subtypes of migraine, namely those characterised by marked dopaminergic symptomatology, has been advanced. From this perspective, a blockade of dopaminergic hyperresponsive receptors can be considered as a rationale for the therapy of migraine.
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PMID:Dopamine involvement in the migraine attack. 1120 Jul 88

A 32-year-old woman presented with a 10-day history of fever (38.0 degrees C), headaches, nausea, vomiting and a 6-month history of diabetes insipidus and amenorrhoea. Two months previously she had undergone a surgical drilling of the right mastoid area because of mastoiditis. Endocrine investigation showed elevated serum prolactin levels, secondary adrenal and gonadal failure and a normal thyroid function. Cranial MRI scan revealed a contrast enhancing intrasellar mass (approximately 2 cm) of heterogeneous appearance with suprasellar extension and thickening of the pituitary stalk. Lumbar puncture was suggestive of aseptic meningitis. The Ziehl-Neelsen stain of cerebrospinal fluid (CSF) and the tuberculin skin test were both negative. The pituitary mass was removed with a transsphenoidal approach. Histological examination demonstrated destruction of the adenohypophysis by epithelioid granulomas with partial caseous necrosis and microabscess formation, suggestive of a mycobacterial infection. A polymerase chain reaction analysis performed on paraffin-embedded tissue was positive for mycobacterial DNA. According to the individual 16S sequence, it was identified as Mycobacterium malmoense, an atypical nontuberculous mycobacterium (NTM). In conclusion, this is the first case of an isolated pituitary granuloma caused by an NTM infection in a nonimmunosuppressed patient.
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PMID:Isolated pituitary granuloma by atypical Mycobacterium in a nonimmunosuppressed woman. 1184 56

A 54 year old man was referred to the department of neurosurgery for frontal headache and vomiting. The patient was known in the department because of previous multiple surgery for a locally invasive pituitary prolactinoma (eight years, three years, and one year previously). The neurological examination revealed a frontal mass, which adhered to the dura, suggesting a meningioma. One year later, a left temporal metastasis was removed. Three months later, the patient died, with spinal metastases, of massive lung embolism. Histology revealed a progression of adenohypophyseal prolactinoma on neuroendocrine carcinoma, with an increase in proliferating indexes and modification of hormone production. This study documents a 10 year history of a rare prolactin producing pituitary carcinoma, which metastasised via liquoral flow.
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PMID:Progression on metastatic neuroendocrine carcinoma from a recurrent prolactinoma: a case report. 1186 14

We report a pregnant woman with a large macroprolactinoma successfully treated with cabergoline after a suboptimal response to bromocriptine. A 7 week pregnant woman with a history of a prolactinoma presented to the endocrine clinic with the complaints of headaches and nausea. She had a prolactin level of 65 microg/L 1 1/2 weeks following her last menstrual period. Bromocriptine was discontinued at 6 weeks gestation when pregnancy was confirmed. A PRL concentration was 1899 microg/L (non-pregnant normal range 1.39-24.20 microg/L, the mean peak levels during pregnancy reported from the literature are 200-210 microg/L) at 7 weeks gestation, and a repeat was 2197 microg/L. An MRI showed a 3 x 2.2 x 2.5 cm seller mass abutting the optic chiasm and displacing the optic nerves superiorly; the visual field testing was normal. Bromocriptine was reinitiated and the patient responded initially with decreasing headaches and declining PRL concentrations to 1488 microg/L at 15 weeks gestation. However, PRL increased to 1836 microg/L at 16 weeks and remained elevated despite bromocriptine 2.5 mg three times a day; in addition, she complained of severe nausea, vomiting, and persistent headaches. Cabergoline was added at 18 weeks gestation. PRL decreased dramatically from 1710 to 859 microg/L in 1 week, and to 488 microg/L within 4 weeks. A repeat MRI showed more than 30% reduction in tumor size. Bromocriptine was discontinued at 24 weeks gestation; she was maintained on cabergoline 0.5 mg twice a week without complaints. PRL levels ranged from 190 to 278 microg/L during the last 10 weeks of pregnancy. She had a C-section electively at 37 weeks gestation and delivered a healthy baby. Management options in this patient and during pregnancy are discussed.
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PMID:Successful treatment of a large macroprolactinoma with cabergoline during pregnancy. 1213 91

The efficacy of three oral formulations (gelatin capsule, tablet, oil base) and five dosages (50, 100, 250, 500, 1000 microg) of cabergoline to disrupt reproduction in coyotes (Canis latrans) was evaluated. The type of formulation used had no effect on plasma progesterone and prolactin concentrations or on mean litter size. No adverse side effects (for example, vomiting, anorexia, diarrhoea) were observed despite the use of doses of up to 20 times the therapeutic dose used for domestic dogs and cats. All coyotes treated with 50, 100, 250 and 500 microg cabergoline whelped, but plasma progesterone concentrations in these coyotes were lower (P < or = 0.07) than in control animals at day 7 after treatment. Ten of 11 females treated with 1000 microg cabergoline whelped, but progesterone concentrations in these coyotes were lower than in control animals up to day 14 after treatment (P < or = 0.04). Dosages of 1000 microg cabergoline decreased blood serum prolactin (P < or = 0.10) and progesterone (P < or = 0.06) concentrations, but apparently failed to decrease progesterone below the threshold necessary to maintain pregnancy in all but one animal. However, progressive inhibition of prolactin and progesterone with increasing doses of cabergoline indicated that higher dosages might be effective in coyotes. Survival of pups born to cabergoline-treated females was not different (P < 0.001) from that of pups born to control females, but mean litter size was smaller for females treated with cabergoline (P < or = 0.073) than for the control females. Although all cabergoline treatments in this study were ineffective at preventing reproduction in coyotes, progressive inhibition of prolactin and progesterone with increasing dosages of cabergoline indicates that higher doses might be effective in preventing reproduction in coyotes. However, the physiological differences from other canine species in dopamine D2 receptors and mechanisms of luteal support may ultimately prevent the use of cabergoline for reproductive control in coyotes.
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PMID:Assessment of cabergoline as a reproductive inhibitor in coyotes (Canis latrans). 1222 Jan 64

An experimental drug - bromocriptine - apparently restores menses and suppresses prolactin production in women with amenorrhea and galactorrhea. Side effects such as nausea, vomiting, lightheadedness, and mild ankle edema usually abate after the first few weeks of therapy. In a study of 13 women with elevated prolactin levels who were treated with 2.5 mg of bromocriptone orally twice a day for up to 24 weeks, galactorrhea diminished markedly in all the patients. Only 5 had complete cessation of galactorrhea. Galactorrhea returned in 11 patients when they stopped taking the drug. Menses were restored in 10 of the women after 3-10 1/2 weeks of treatment. 3 women became pregnant before the resumption of menses. The degree of prolactin suppression (reduced to less than 20 ng/ml in a patient) failed to correlate well with early or late resumption of menses or conception.
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PMID:New drug helps women with "post-pill" problem. 1222 78

3 conditions may be responsible for absence of menstruation in women taking the minipill: pregnancy, extrauterine pregnancy, or endometrial atrophy which is the most frequent cause but should be treated only after the other 2 possibilities are excluded. The most frequent cause of pregnancy while taking minipills is error in pill consumption due to forgetting, but malabsorption due to vomiting less than 2 hours after taking the pill or an interaction with some other medication may be responsible. The possibility of extrauterine pregnancy should be systematically considered, and the possibility that a micropill and not a minipill is involved should be ruled out. With a sequential minipill contraceptive efficacy does not reach 100% but iatrogenic amenorrhea is infrequent because of the strong dose of ethinyl estradiol. In the case of a preexisting amenorrhea that does not respond to the estrogen or progestin dose, a prolactin adenoma may be suspected. After 2 consecutive beta tests of pregnancy 8 days apart have been negative, it may be concluded that endometrial atrophy is the cause of the amenorrhea. Unprotected sexual relations should be avoided and the patient should be given a fast-acting combined oral contraceptive such as Lutestral to induce bleeding, after which the minipill can be resumed. If unprotected intercourse occurs there is a risk of pregnancy since amenorrhea and anovulation are not synonymous. A morning after pill can be used if the unprotected sexual relations occurred within the last 72 hours. If a pill was forgotten or probably forgotten before the emenorrhea, the most prudent attitude would be to consider the pill to have been ineffective during the preceding 21 days and to test for pregnancy. Unprotected intercourse should be avoided, a fast-acting combination pill should be prescribed to induce bleeding, and the minipill should then be resumed. Amenorrhea in the 1st month of use after an abortion is not significant. This secondary effect of the minipill should be explained to the patient to avoid unnecessary worry.
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PMID:[Do's and don'ts in treating amenorrhea in women taking the minipill]. 1226 2


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